肾上腺皮质癌组织中COX-2蛋白表达与临床病理特征及预后的关系研究

Relationship of expression of COX-2 with clinicopathological parameters and prognosis in adrenal sebaceous carcinoma tissues

目的探讨肾上腺皮质癌(ACC)组织中环氧合酶-2(COX-2)蛋白表达与临床病理特征及预后的关系。方法从癌症基因组图谱(TCGA)数据库中获得51例经手术病理确诊为ACC的患者,术后随访3年。比较癌组织、癌旁组织中COX-2蛋白阳性表达率;分析不同临床病理特征ACC患者癌组织中COX-2蛋白阳性表达率的差异;多因素Cox比例风险模型分析影响ACC患者预后的因素;分析癌组织中COX-2阳性表达与ACC患者生存的关系。结果ACC患者癌组织中COX-2阳性表达率高于癌旁组织中COX-2阳性表达率(P<0.05)。低分化、Ⅲ期、CD56阳性、Syn阳性、Ki-67表达≥10%、微血管侵犯的ACC患者癌组织中COX-2阳性表达率分别高于中高分化、Ⅰ和Ⅱ期、CD56阴性、Syn阴性、Ki-67表达<10%、未合并微血管侵犯的ACC患者癌组织中COX-2阳性表达率(P<0.05)。多因素Cox比例风险模型分析结果显示,病理分级[RR=4.904(95%CI:2.018,11.918)]、分期[RR=6.025(95%CI:2.479,14.644)]、内分泌功能[RR=3.927(95%CI:1.616,9.545)]、Ki-67[RR=4.011(95%CI:1.650,9.748)]、COX-2阳性[RR=5.114(95%CI:2.104,12.429)]是影响ACC患者术后复发的危险因素(P<0.05);病理分级[RR=4.914(95%CI:2.022,11.942)]、分期[RR=6.633(95%CI:2.729,16.119)]、内分泌功能[RR=4.003(95%CI:1.647,9.728)]、COX-2阳性[RR=5.296(95%CI:2.179,12.872)]是影响ACC患者术后生存的危险因素(P<0.05)。COX-2阳性表达患者与COX-2阴性表达患者的无病生存曲线及总存活曲线比较,差异有统计学意义(P<0.05)。结论ACC患者癌组织中COX-2蛋白阳性表达与临床病理特征及预后有关,COX-2阳性患者预后不良风险高。

Objective To investigate the relationship of the expression of cyclooxygenase-2(COX-2)with clinicopathological parameters and early recurrence after resection in adrenal sebaceous carcinoma(ACC)tissues.Methods Fifty one patients assessed with COX-2 gene expression with ACC in The Cancer Genome Atlas(TCGA)and were followed up for 3 years postoperatively.Immunohistochemistry was used to detect COX-2 protein expression;COX-2 protein expression in cancer tissues and paracancerous tissues were compared;The relationship between COX-2 expression in cancer tissues and clinicopathological parameters,factors affecting the prognosis,and the relationship between COX-2 expression in cancer tissues and survival of ACC patients were analyzed.Results The positive expression rate of COX-2 in cancer tissues of ACC patients was higher than that of paraneoplastic tissues(P<0.05).The COX-2 positive expression rates in cancer tissues of ACC patients with low differentiation,stageⅢ,CD56 positive,Syn positive,Ki-67 expression≥10%,and microvascular invasion were higher than those with moderate to high differentiation,stageⅠtoⅡ,CD56 negative,Syn negative,Ki-67 expression<10%,and no combined microvascular invasion,respectively(P<0.05).Cox regression analysis showed that pathological grade[RR=4.904(95%CI:2.018,11.918)],stage[RR=6.025(95%CI:2.479,14.644)],endocrine function[RR=3.927(95%CI:1.616,9.545)],Ki-67 expression[RR=4.011(95%CI:1.650,9.748)]and COX-2 positive[RR=5.114(95%CI:2.104,12.429)]were risk factors affecting postoperative recurrence in ACC patients(P<0.05).Cox regression analysis showed that pathological grade[RR=4.914(95%CI:2.022,11.942)],stage[RR=6.633(95%CI:2.729,16.119)],endocrine function[RR=4.003(95%CI:1.647,9.728)],and COX-2 positive[RR=5.296,(95%CI:2.179,12.872)]were risk factors affecting the postoperative survival of ACC patients(P<0.05).The differences in disease-free survival curves and overall survival curves between patients with positive COX-2 expression and patients with negative COX-2 expression were statistically significant(P<0.05).Conclusion COX-2 protein expression in cancer tissues of ACC patients is related to clinicopathological parameters and prognosis,and COX-2-positive patients have a high risk of poor prognosis.